Evidence Based Training Strategies to Improve Clinical Practice in Endovascular Aneurysm Repair

Doyen, Bart; Bicknell, Colin; Riga, Celia; Herzeele, Isabelle Van

doi:10.1016/j.ejvs.2018.08.007

Cited by 3 publications

(2 citation statements)

References 68 publications

(65 reference statements)

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“…The current global shift in medical education towards a competency-based approach has been widely adopted in the vascular community. 14,16,17 There is an increasing amount of evidence for simulation-based training of both open and especially endovascular skills and patient-specific simulation in EVAR has shown unequivocal and favorable results. 7,9,17,18 Most studies investigating simulation-based EVAR training focus on technical skills and graft implantation and overlook one important issue for a successful implementation, namely sizing and graft selection.…”

Section: Discussionmentioning

confidence: 99%

“…14,16,17 There is an increasing amount of evidence for simulation-based training of both open and especially endovascular skills and patient-specific simulation in EVAR has shown unequivocal and favorable results. 7,9,17,18 Most studies investigating simulation-based EVAR training focus on technical skills and graft implantation and overlook one important issue for a successful implementation, namely sizing and graft selection. 8,[11][12][13] To investigate the gap on how vascular surgery trainees without prior EVAR experience could learn basic EVAR sizing and stent graft selection, the results of a one-day intensive planning and sizing workshop for basic infra-renal aortic repair were studied using a previously validated assessment test of competence.…”

Section: Discussionmentioning

confidence: 99%

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Learn EVAR sizing from scratch: The results of a one-day intensive course in EVAR sizing and stent graft selection for vascular trainees

et al. 2020

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Background and aim Recognition of structured training in endovascular aortic repair (EVAR) for vascular trainees is increasing. Nevertheless, how trainees can achieve sufficient skills in EVAR sizing and graft selection is sparsely described. The aim of this study was to investigate the effect of systematic training in basic EVAR sizing and graft selection on vascular surgery trainees using a validated assessment tool. Methods Sixteen vascular surgery trainees were included in an intensive 6-h hands-on workshop in aortic sizing and stent graft selection for EVAR with a trainer-to-trainee ratio of 1:2. After 1-h lecture, participants did 5 h of supervised training on increasingly complex cases. Finally, the participants were tested using a validated assessment tool. Results All participants were able to size the test-case and select a stent graft combination in 24:35 (13:30–48:20) min (median and range). The participants’ overall test scores (lower is better) were in median 17.9 (11.9–28.4). This did not differ from the scores of experienced EVAR operators 14.7 (11.7–25.2) (<200 EVAR’s) ( p = .32) but was inferior to the score of EVAR experts 11.2 (9.8 –18.7) (≥200 EVAR’s) ( p = .01). The sub-score for anatomical measurements was 10.6 (3.9–18.8) and comparable with the experienced group 9.7 (8.1–12.8) ( p = .83) but inferior to the expert operators 6.5 (5.2–10.2) ( p = .04). The sub-score for stent graft selection was 7.5 (4.9–14.1) and comparable with experienced operators scoring 4.5 (3.6–12.3) ( p = .09) but inferior to the expert operators score of 5.0 (3.6–8.4) ( p = .01). Conclusion This study presents the results of a standardised one-day basic EVAR sizing and graft selection workshop. Vascular surgery trainees with no prior EVAR experience learned to size and select stent grafts for a simple infra-renal AAA on par with experienced EVAR operators.

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